Harry Faust quickly was back in the driver's seat after colon surgery, thanks to a new procedure called TEM that also saved him from having to wear a colostomy bag.

Colorectal Cancer
New surgical procedure save lives and quality of life for those with the disease that, when caught in time has a cure rate of more than 90 percent
 Reading Eagle/Reading Times - December 21, 1999
By Tracy Rasmussen

Colorectal cancer affects more people in Berks County than any other cancer. Nationally, it's second only to lung cancer as a killer.

Yet what separates colon cancer from many other forms of cancer from many other forms of cancer is that -- caught early -- the cure rate is more than 90 percent.

So why do so many people die?

Harry Faust of Deer Lake, Schuylkill County, a colorectal cancer survivor, sums it up in one word: fear.

"I was so afraid that I'd have to weak that bag" said Faust, referring to a colostomy bag that is worn outside the body to collect solid waste in patients who have had portions of their colon removed.

His fear was justified. When he went to a doctor in Pottsville in February, he was told the cancerous tumor was so low in his colon it was likely the entire rectum would have to be removed.

"He told me that he'd never seen one so low that you wouldn't need a bag," Faust said. "But I told him I wanted a second opinion. And he told me that if anyone could save me from wearing the bag, it was Dr. Marks."

COLON CANCER STATISTICS
Colorectal cancer is one of the most common cancers in Berks County, occurring in nearly 300 new patients per year. It accounts for approximately 14 percent of all cancers reported in the county.

Although scientists are unsure what causes colorectal cancers, studies have indicated that a diet high in fat and low in fiber contributes to the disease.

Age is also a contributing factor as roughly 90 percent of colorectal cancers occur in people over the age of 50. People who suffer from irritable bowel syndrome (IBS) also appear to be at greater risk for developing cancer.

Colorectal cancers almost always have benign growth on the intestinal walls called polyps, which are visible in routine colon testing.

In addition to regular cancer screenings, a diet high in fiber (at least 25 grams per day) and low in fat is recommended to combat colorectal cancer.

This data was complied from the American Cancer Society and the State Center for Health Statistics and Research, Pennsylvania Department of Health in Harrisburg. Cancer statistics are from 1996, the most recent year for which figures have been compiled.

Dr. John H. Marks and his father Dr. Gerald J. Marks are pioneers in the treatment of colon cancer using Laparoscopic surgery as well as Transanal Endoscopic Microsurgery (TEM) to save both lives and quality of life.

"For some patients it is a quality of life issue," John Marks said. "TEM allows me to operate ion the rectum through the anus."

Since less of the rectum is removed, a colostomy is rarely needed. Patients also heal more quickly because there is no incision outside of the body.

Traditional abdominal surgery requires four to six weeks recovery; TEM and laparoscopic surgeries can cut the recovery time in half.

TEM surgery also is dependent upon the tumor being relatively small. Faust had five weeks of both radiation and chemotherapy prior to his surgery.

He said it shrunk his tumor to 20 percent of its original size.

"And I didn't get sick," he said. "I didn't have any side effects from the chemo at all. Didn't lose any hair or anything."

Faust wore a 24-hour-a-day chemotherapy pump that cycled medication into his system through a port in his upper chest. He said he found the radiation therapy annoying by the end of his treatment.

"It's like sticking you butt in a microwave," he said. "That's the best way I can describe it."

Following chemo and radiation Faust checked into Lankenau Hospital for the procedure on September 2, 1999. He stayed in the hospital for five days and went home "feeling great," he said.

"I wasn't in any pain at all," he said. "And now I am 100 percent fine."

Faust said he was told to watch his diet and omit dairy products as well as fresh fruits and vegetables, which can be difficult for healing colons to digest.

Nearly four months after his surgery, Faust said he "eats a little of everything now. I haven't had any problems. I'm normal.

Faust says he happy he paid attention to the cancer warning signal that he noticed.

"I saw blood (in his stool) and I called the doctor right away," he said. "I didn't have any other symptoms."

He's also happy his fear didn't keep him from getting a second opinion.

"All I can say is that I'm glad that I did and that Dr. John Marks is a very special person," he said.

COLON CANCER SYMPTOMS
 The following symptoms, compiled by the American Cancer Society, may indicate colon cancer and should be evaluated by your physician.

  • A change in bowel habits such as diarrhea, constipation, or a narrowing of the stool that lasts more than a few days.
  • Bleeding from the rectum or blood in the stool
  • Cramping or gnawing stomach pain
  • Decreased appetite, weakness and fatigue
  • Jaundice

The American Cancer Society suggests that colon cancer testing be done in men and women beginning at the age of 50; earlier if there is a family history of polyps.

The ACS suggests yearly fecal occult blood tests every year and either flexible sigmoidoscopy and digital rectal exam every five years or a colonoscopy every 10 years.

Marks has performed nearly 40 TEM surgeries, learning the procedure from its inventor, German surgeon Dr. Gerhard Buess, in the mid 1990s.

Marks said not everyone with colon cancer is a candidate for TEM, which is helpful only to people with lesions (cancerous or benign) in the rectum.

Laparoscopic colon surgery, however, is a growing way to treat many other colon cancers as well as colon disease such as diverticulitis

"Last week I took out five feet of patient's colon," Marks said.

" I was able to do that laparoscopically."

He likened these advances to colon cancer surgery to the advances made during the last 20 years in breast cancer treatment.

"It wasn't long ago that women needed a radical mastectomy," he said. "Then there were modified mastectomies and now many women are treated with lumpectomies."

Laparoscopic surgery is done through a small incision into which a camera is inserted. It allow surgeons to pinpoint the area of disease and excise it.

"I think that's the direction we need to go in," Marks said. "Technically it's very challenging."

Marks said laparoscopic surgery can be performed in many more cases than TEM.

"It depends on the size of the lesion," he said. "If it's very large and the incision for the laparoscopy has to be large, it's not worth it. But in many cases, we can do this procedure."

Marks said the success rate coupled with the improvement in the quality of life makes pioneering this field exciting.

He said of 100 patients who received either laparoscopic or TEM surgery only seven will need permanent colostomies.

"That's a two and a half fold decrease," he said.

"Colon cancer is the No. 2 (cancer) killer," Marks said. "And it affects both women and men. If detected early it's very curable. Laparoscopy and TEM are tools that allow us to do that."